Growth & Development Milestones: Toddlerhood->Adolescence

Explain the physical growth of the toddler from 1-2 years:

Weight: Gains 227 g (8 oz) or more per month Height: Grows 9-12 cm (3.5-5in) during this year

ANTERIOR FONTANELLE CLOSES BETWEEN THE 1-2ND YEAR. (BY 18 MONTHS)

just know that birth weight doubles at 6 months old, triples at 1 year, and quadruples by 2 years - then after that it's individualistic

What are the fine motor skills of the toddler from 1-2 years?

-just coming out of infancy remember, so these skills won't be crazy yet

-By end of the second year, will be able to build a tower of 4 blocks

-scribble on paper

-CAN UNDRESS SELF

-throw a ball

when can a child first learn to undress themselves?

during 1-2 years of toddlerhood. Undressing comes before dressing. Think of a toddler trying to pull their clothes off

when can a child build a tower of 4 blocks?

by the end of their 2nd year

when can a child scribble on paper?

1-2 years old

when can the child first throw a ball?

1-2 years

When can a child first learn to run?

1-2 years - but is very clumsy

This is when a child shows a growing ability to walk and finally walks with ease

1-2 years toddlerhood

walks up and down stairs after a few months of learning how to walk with ease

1-2 years

likes push-pull toys

1-2 years

this is when the child's visual acuity is getting better, at around 20/50

toddlers 1-2

What are the gross motor abilities of the toddler?

-Runs - but falls down a lot

-Shows growing ability to walk, learns to walk with ease, then learns to walk up and down steps

-likes push pull toys - helps with walking with ease and learning balance

Major milestones: Builds a tower of 4 blocks

1-2 years. By end of second year they should be able to.

Major milestone: Able to scribble on paper

1-2 years

Major milestone: undress self

1-2 years

Major milestone: when can the child dress themselves?

2-3 years.

so early toddlerhood they can undress self, late toddlerhood they can dress self.

major milestone: walks up and down stairs

1-2 years; after learning to walk with ease

Milestone: likes using push-pull toys

toddlerhood 1-2 (ex: shopping cart, vacuum toy)

when does the anterior fontanelle close?

1-2 years; 18 months *

when does the posterior fontanelle close?

2-4 months. BY 4 MONTHS.

When can the child draw a circle and other rudimentary forms?

toddlerhood 2-3 years

when does the child learn to pour?

toddlerhood 2-3

what are the gross motor skills of toddlers 2-3?

jump, kick ball, throw ball overhand

Toddlers 1-3 refine their motor skills by using what type of toys and play?

what can help refine their fine motor skills?

gross motor?

cognitive skills?

-cloth books, large pencil and paper, wooden puzzles (things to help them increase fine motor skills)

-they like imitative behavior by playing kitchen, grocery shopping, toy telephone

-gross motor skills increasing - riding a Big Wheel tricylce, playing with a soft ball and bat, molding water and sand, tossing ball or bean bag

cognitive skills develop for them with exposure to educational tv shows, music, stories, and books

this age group increasingly enjoys talking

toddlers 1-3 - think bc now they have learned a new thing, language! They're using it. They have an exponential growth in their vocab, especially when spoken to and read to

explain the communication of a toddler 1-3

-increasingly talkative

-vocab is growing

-HAS A VOCAB OF NEARLY 1,000 WORDS AND USES SHORT SENTENCES - by the end of toddlerhood (in the beginning they use short words in addition to mama and dada)

- they need to relieve stress by pounding board, freq gross motor activites, and temper tantrums - teach parents this is normal. They don't have the words yet to express a want or need. They're frustrated.

-They like contact with other children and learn interpersonal skills

What are some strategies for communicating with a toddler?

-Give short, clear instructions

-do not give choices if none exist

-offer two alternatives when possible - reasonable choices

-approach toddlers positively and slowly, allowing them time to adjust to you

-tell the toddler what you are doing, and say the names of objects

- use simple terminology - whenever you do something painful "we do this to make sure you get better" ,etc

-allow the toddler to cry and acknowledge that it must be frightening and you understand

Do not give this age group warning too far in advance, they don't understand time and will get anxious

toddlers 1-3

Name some distraction activities for the toddler to use to lessen pain and anxiety:

massage, pinwheels, stories, bubbles, touch, holding, rocking, music

What stage of Erikson are toddlers 1-3 in? and explain it.

Autonomy vs. Shame and Doubt - the child is increasingly independent in many spheres of life.

*The toddler's sense of autonomy or independence is shown by controlling body excretions, saying no when to do something, and directing motor activity and play. Children who are constantly criticized for their expressions of autonomy or for their lack of control (ex during toilet training) will develop a sense of shame about themselves and doubt in their abilities.

-the nurse can help by: allowing the toddler to feed themselves, encourage the child to remove and put on their own clothes, brush their teeth, and assist with hygiene.

What stage of Piaget's are toddlers 1-3 in?

end of sensorimotor stage (1) to beginning of preoperational stage

- the child shows increasing curiosity and exploratative behavior. Language skills improving.

nursing: We can ensure that there's safe surroundings to allow opportunities to manipulate objects. Name objects and give simple explanations. - bc they are learning language, and have a simple mind set so use simple terms. The young child may think by using words as symbols; their logic is not developed yet.

-although their vocab is increasing, they are unable to see things from other's perspectives still.

explain the growth of preschoolers

-they grow slow and steady, most of their growth is in the long bones of their arms and legs

- so the short, chubby toddler gives way to the long-legged, slender preschooler

age 3-6

What are the fine motor abilities of the preschooler?

-uses scissors

-draws circle, square, cross

-draws a 6-part person

-enjoys ART PROJECTS such as pasting, stringing beads, using clay

-learns to tie shoes at the end of the preschool years

-BUTTONS CLOTHES

-brushes teeth

-uses spoon, fork, knife

-eats three meals with snacks

at what age can the child button their clothes ?

preschool 3-6 years

At what age does the child engage in art projects: pasting, stringing beads, using clay, using scissors, drawing shapes, drawing people?

preschool 3-6 years

When does the child learn how to tie their shoes?

At the end of the preschool years

when does the child learn to use a knife, fork, and spoon?

preschool 3-6 years

when does the child start to eat three meals with snacks?

preschool 3-6 years - toddlers are picky eaters! Usually they'll try to drink their meals

When does the child learn to brush their teeth?

preschool 3-6 years

Major milestones: uses scissors

preschool 3-6 years

major milestone: ties shoes

preschool 3-6 years

(the toddler can really only dress and undress themself-where the preschooler can button thier clothes)

What are the gross motor abilities of the preschooler?

throws a ball overhand

climbs well

rides bike with training wheels

what are the sensory abilities of the preschooler?

their visual acuity continues to improve

- they are bale to focus on and learn letters and numbers

preschoolers engage in what type of play

associative or interactive

toddlers - parallel

infants - solitary

what type of toys would you suggest for a child 3-6?

These children do ASSOCIATIVE/INTERACTIVE play and also DRAMATIC play

associative: playing simple games, puzzles, nursey rhymes, songs

dramatic play - fostered by dolls and doll clothes, play houses, hospitals, dress up clothes, puppets

stress for preschoolers is relieved by pens, paper, glue, scissors

cognitive growth is fostered by educational tv shows, music, stories, and books

What age group engages in dramatic play?

preschool - dressing up or playing out the drama of real life.

How do preschoolers relieve stress?

by pens, paper, glue, scissors, crafts, drawing - child life therapists use this sometimes to see how children are feeling

This is when all parts of speech are first developed and used, but occasionally incorrectly

preschool 3-6 years

-communicates with a widening array of people

-play with other children is a favorite activity

Name some strategies for communicating with preschoolers:

-allow time for the child to integrate explanations

-verbalize freq. to the child - they like to talk

-use drawings and stories to explain care

-use accurate names for body functions

-allow choices

Name some distraction activities for the preschooler

puzzles, action figures, being a superhero, kaleidoscopes, books, videos

- they like crafts and dramatic play

What stage of Erikson is the preschooler in?

3-6 years = Initiative vs. Guilt stage: the child now likes to initiate activities and has new ideas

-The young child initiates new activites and considers new ideas. This new interest in exploring the world creates a child who is BUSY and INVOVLED. So constant criticism on the other hand, leads to feelings of guilt and a lack of purpose.

nursing care: offer medical equipment to the child to play and lessen their anxiety about strange objects; assess children's concerns as expressed through their drawings. Accept the child's choices and expressions of feelings

What stage of Piaget is the preschooler in?

Preoperational stage (same as toddlers)

-although the child is increasingly verbal, they still have limitations in their thought processes.

-causality is often confused, so the child may feel responsible for causing an illness **

-their cause and effect relationship way of thinking is unrealistic, or a result of magical thinking.

-they may also give life to an inanimate object bc they move, make noise, or have certain qualities.

-only able to consider one aspect of a situation at a time

nursing care: we can offer explanations about procedures and treatments. Clearly explain that the child is not responsible for causing an illness in themselves, or a family member.

what is magical thinking and what age group does it?

Magical thinking = the belief that events occur because of their own thoughts or wishes; so they feel responsible for illness or hospitalizations.

-occurs in preschoolers **

(and ages 4-7 years)

* part of Piaget's theory of having PREOPERATIONAL THOUGHT.

this age group understands the concept of conservation

schoolage 6-12 years

What are the fine motor abilities of the schoolage child ?

-enjoys craft projects

-plays card and board games

What are the gross motor abilities of the school-age child?

RIDES A TWO WHEELER!

Jumps rope

roller skates or ice skates

What are the sensory abilities of the school-age child?

can read

-is able to concentrate for longer periods on activities by filtering out surrounding sounds

at what age is the child able to read?

school-agee

At what age is the child able to concentrate on activities for a longer period of time.

ex: karate

school-age

what age group enjoys craft projects, board games, and playing cards?

school-age

The front teeth are lost around what year?

6 years (so end of preschool, start of school-age)

This age group enjoys participating in sports; they begin to lose fat while developing muscles and they appear leaner now than earlier stages

school-age

For the school-age child:

gross motor development is fostered by what activities?

Fine motor?

cognitive?

Gross: sports, ball sports, skating, dance lessons, skiing, biking

fine: a sense of industry is fostered by playing an instrument

-also by collecting items, starting hobbies, playing board games, and video games

cognitvie growth: by reading, doing crafts, word puzzles, schoolwork

Explain the communication of school-age children

-they have mature use of language now

-ability to converse and discuss topics for increasing lengths of time

-spend many hours at school and with friends, in sports or other activities

Name some communication strategies for talking to school-age children

-assess their knowledge before teaching

-provide concrete examples of pictures or materials to accompany verbal descriptions (bc remember their thinking is concrete!)

-allow the child to select rewards following procedures

-teach techniques such as counting, or visualization to manage difficult situations

-include the child in discussions and hx with parents

-be honest in explanations and all communciations - THESE ARE THE RULE FOLLOWERES.

Name some distraction activities for school-age children

rhythmic breathing, muscle relaxation, guided imagery, talking about pleasant experiences, playing games, watching a video, video games

name some distraction techniques for adolescents

similar to school-age children - rhythmic breathing, muscle relaxation, guided imagery, having visitors, video games, watching videos, listening to CD player or iPod

What is a Buzzy for Shots and how does it work

It is a device that has a cold pad placed against the skin and a buzzing bee that vibrates.

-buzzy gets placed over the site of the needlestick for 30 seconds and then is moved back proximally during the shot.

-the cold and vibration stimulation interfere with pain transmission, and also this provides DISTRACTION for the child

** so it uses cold and vibration stimulation to reduce pain transmission and act as a distraction during shots

What Eriskon stage are school-age children in?

Industry vs. Inferiority

- the child gains a sense of worth from involvement in activities

-the middle years of childhood are characterized by development of new interest and involvement in activities. The child takes pride in accomplishments like sports, school, home, and community. If the child cannot accomplish what is expected, the results will be that they feel inferiority.

nursing: we encourage the child to continue with their schoolwork while hospitalized

-encourage the child to bring their favorite pastimes to the hosptial

-help the child adjust to limitations on their favorite activities

What stage of Piaget's cognitive development are school-age children in?

Concrete operational stage:

the child is capable of mature thought when allowed to manipulate and see objects - meaning they need to see things concretely to really understand.

-these children are starting to understand cause and effect more. The child is able to reason quite well IF CONCRETE OBJECTS are used in teaching or experimentation. The concept of conservation is learned at this age

nursing care: we give school-age children clear instructions about details of treatment. Show the child equipment that will be used in treatment.

The concept of conservation is established in what age group

school-age children, the concrete thinkers.

In these years, the conscience or ethical standards becomes important

kohlberg's theroy of moral development; rules important; Concentional Morals - kids aged 7-12 years - so the school-age children.

Explain the growth of adolescents

age 12-18

-there's variations in their growth spurts

-girls growth spurt occurs first around age 9-10

-boys happen one year after, maybe at 10 years

Fine motor skills are well developed at this age

12-18 adol. ex: painting fingernails

What are the gross motor skills acquired for adolescents?

-maturity leads to new activities

-they try new sports activities

-muscle devleopment continues

-some lack of coordination is commong during growth spurts

Nmaeosomeoftheactivities

Name some activities that adolescents like to do

Sports - ball games, gymnastics, water and snow skiing/boarding, swimming, school sports

school activities - drama club, yearbook, class office, club participation

Quiet activities: reading, schoolwork, television, computer, video games, music

Explain the communication of adolescents

increasing communication and time spent with peer group - go to movies, dances, driving, eating out, attending sports events

able to apply ABSTRACT THOUGHT and anaylsis in conversations at home and school

What stage of Erikson is the adolescent child in?

Identity vs. Role Confusion

-the adol. searches for self identity, leading to independence from their parents, and reliance on peers

-in this age group, the body matures and thought processes do too, becoming complex - so a new sense of identity or self is established. The self, family, peer group, community, are all examined and refined in these years. The adolescent who is unable to establish a meaningful definition of self will experience confusion in one or more roles of their life.

nursing care: provide a separate recreation room for teens who are hospitalized

-take a health history and perform exams without parents present

-introduce adolescent to other teens with same health problem **

What stage of Piaget's cognitive theory are adolescents in?

Formal operational thought - the child is capable of mature, abstract thought.

-FULLY MATURE INTELLECTUAL THOUGHT NOW ESTABLISHED. The child can think abstractly about objects or concepts and consider different alternatives or outcomes. No longer concrete, black and white thinking like school-age kids.

nursing care:give them clear and complete information about health care and treatments.

-offer them both written and verbal instructions

-continue to provide education about the diseases to the adolescent with a chronic illness, bc now they have mature thought which leads to greater understanding